Aburto, J

Kashnitsky, I

Kashyap, R

Schöley, J

Aburto, Jose

Oxford University Research Archive

7. Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L.Excess deaths from COVID-19 and other causes, March-April2020. JAMA 2020;324:510–13.8. Australian Bureau of Statistics. Provisional Mortality Statistics.2021. https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release (28 December 2021,date last accessed).9. Australian Bureau of Statistics. Number of Deaths, by Sex,Selected Age Groups, and Cause of Death, Period 2019. 2020.https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia (28 December 2021, date last accessed).10. Bureau of Infrastructure and Transport Research Economics. RoadDeaths Australia – September 2021, Canberra: BITRE, 2021.11. Lopez AD, Adair T. Slower increase in life expectancy inAustralia than in other high income countries: the contributionsof age and cause of death. Med J Aust 2019;210:403–09.International Journal of Epidemiology, 2022, 1695–1697https://doi.org/10.1093/ije/dyac055Advance Access Publication Date: 28 March 2022Life expectancy declines in Russiaduring the COVID-19 pandemicin 2020José Manuel Aburto ,1,2,3,4*† Jonas Schöley,3,4† Ilya Kashnitsky 3† andRidhi Kashyap 1,2†1Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK, 2NuffieldCollege, Oxford, UK, 3Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense,Denmark and 4Max Planck Institute for Demographic Research, Rostock, Germany*Corresponding author. Department of Sociology, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, UK. E-mail:jose-manuel.aburto@sociology.ox.ac.uk†All authors contributed equally to this letter.Received 26 October 2021; Editorial decision 10 March 2022; Accepted 14 March 2022Our recent study of 29 countries, which was published inIJE, highlights the devastating impact of the COVID-19pandemic on mortality across high-income countries.1Period life expectancy witnessed declines in 2020 on ascale that is unprecedented in recent history. With the re-cent availability of data from Russia,2 we show that Russiais no exception (Figure 1). Data from death registrationsindicate that life expectancy between 2019 and 2020 inRussia fell by -1.68 (95% CI: -1.72, -1.63) years amongmales (from 68.41 to 66.73 years) and -1.80 (95% CI: -1.85, -1.76) years for females (from 78.44 to 76.64 years).Comparisons of these losses with those among the 29countries, as we previously reported,1 reveal that life ex-pectancy losses among females were the largest in Russia,and losses among males stand only behind the USA(2.2 years) and Lithuania (1.7 years).Two features of the pandemic’s impact on Russian mor-tality stand out. First, similar to what we found for theUSA, increased mortality in working, mid-life ages (20 to60) accounted for 26% of the total life expectancy declinefor women and 33% for men. Since at least 1960, Russiahas been the country with the lowest male life expectancyand highest lifespan inequality in Europe, due to a contin-ued burden of mid-life mortality.3 Failure to reduce theprevalence of cardiovascular diseases combined with highlevels of alcohol consumption and violence led to these pat-terns.4 However, healthier behaviours, better health careand socioeconomic development have led to sizeableimprovements in mortality in recent years preceding theCOVID-19 pandemic.4 In this context of significant pro-gress, the more than one million estimated excess deathsby the end of 2021 [https://github.com/dkobak/excess-mortality],5,6 and the life expectancy declines triggered by ex-cess mortality in mid-life and older-age groups, highlightthe catastrophic toll of the pandemic in Russia. To put thisinto an international perspective, Russia’s level of excessdeaths is among the highest across European countries.5,7Second, sex differences in mortality observed in Russiaare striking (Figure 2). Although in most of the 29 coun-tries, we found life expectancy losses to be larger amongmales than females,1 in Russia females experienced largerlosses. A potential explanation for the Russian pattern maylie in the heightened exposure to COVID-19 infectionexperienced by health care workers aged between 20 andInternational Journal of Epidemiology, 2022, Vol. 51, No. 5 1695VC The Author(s) 2022. Published by Oxford University Press on behalf of the International Epidemiological Association.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unre-stricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Downloaded from https://academic.oup.com/ije/article/51/5/1695/6555070 by guest on 21 December 202260 during the pandemic, who are predominantly women,8but a deeper assessment of these sex differences is needed.Life expectancy losses in Russia in 2020 reveal that theywere on a scale comparable to those observed in anothersimilarly large and heterogeneous country, the USA.Russia’s decline in life expectancy may even be larger inmagnitude relative to the USA when compared with theprojected life expectancy in 2020,9 particularly as Russia’srecent progress in life expectancy improvements has beensignificant compared with the stalls in improvements in theUSA. The lack of a streamlined national response, coupledwith persistent regional disparities in the implementationand uptake of non-pharmaceutical interventions,10,11 andsignificant ethno-racial inequalities, are likely to have beenfactors underlying the significant mortality impacts in bothcountries.6,12 In Russia, adherence to non-pharmaceuticalinterventions has been weak and uneven across regions,and distrust in government may have further affected ad-herence substantially over the course of the pandemic.13,14The outlook for life expectancy in 2021 is pessimistic asbelated efforts to increase vaccination uptake in responseto the summer spread of the ‘delta’ variant were subse-quently loosened in preparation for parliamentary elec-tions in September 2021, coupled with a strong reluctanceto be vaccinated.10 National figures are important and in-formative, but they conceal variation at the sub-nationallevel and by socioeconomic and ethno-racial groups.Evidence from other large and heterogeneous countries, suchas Brazil and Mexico,15,16 suggests that life expectancy lossesmay be more severe in certain regions and larger forFigure 1 Life expectancy at birth by sex for Russia from 2015 to 2020. The inset shows the age-specific contributions to the change in life expectancyfrom 2019 to 2020 by sex; 95% prediction intervals via Poisson sampling of age-specific death counts18Figure 2 Sex differences in the life-expectancy change from 2019 to 2020 across countries experiencing life expectancy losses; 95% prediction inter-vals via Poisson sampling of age-specific death counts1696 International Journal of Epidemiology, 2022, Vol. 51, No. 5Downloaded from https://academic.oup.com/ije/article/51/5/1695/6555070 by guest on 21 December 2022disadvantaged groups.12 Similarly, the spread of COVID-19and associated mortality varied between regions in Russia.7Further disaggregated analyses will be needed to understandthe evolution of the pandemic and its toll on mortality out-comes, as well as the impact of the more than one million ex-cess deaths up to December 2021.5 Moreover, continuedpoor levels of vaccine uptake in Russia and among Russian-speaking communities across other post-soviet states, in theBaltic countries and Eastern Europe,17 indicate that the mor-tality impacts of the pandemic in these countries in 2021 mayyet be worse than in 2020.Ethics approvalThis research project does not require ethics approval as it uses onlymacro data that are freely available online.Data availabilityThe replication files for this paper include customized functionalitywritten in the R statistical programming language. The code, and allharmonized input and output data pertaining to our analysis, arehosted on GitHub [https://github.com/oxforddemsci/ex2020].Author contributionsConceptualization: J.M.A., J.S., I.K., R.K. Data curation: J.M.A.,J.S., I.K., R.K. Formal analysis: J.M.A., J.S., I.K., R.K.Methodology: J.M.A., J.S., I.K., R.K. Software: J.M.A., J.S., I.K.Visualization: J.S. Project administration: J.M.A., J.S., I.K., R.K.Supervision: J.M.A., J.S., I.K., R.K. Writing—original draft: J.M.A.Writing—review and editing: J.M.A., J.S., I.K., R.K.FundingBritish Academy’s Newton International Fellowship grantNIFBA19/190679 (J.M.A., R.K.); ROCKWOOL Foundation’sExcess Deaths grant (J.M.A., J.S., I.K.); Leverhulme Trust LargeCentre Grant (J.M.A., R.K.).Conflict of interestNone declared.References1. Aburto JM, Schöley J, Kashnitsky I et al. Quantifying impacts ofthe COVID-19 pandemic through life-expectancy losses: apopulation-level study of 29 countries. Int J Epidemiol 2022;51:63–74.2. Jdanov DA, Galarza AA, Shkolnikov VM et al. The short-termmortality fluctuation data series, monitoring mortality shocksacross time and space. Sci Data 2021;8:235.3. Aburto JM, van Raalte A. Lifespan dispersion in times of life ex-pectancy fluctuation: the case of central and Eastern Europe.Demography 2018;55:2071–96.4. Grigoriev P, Meslé F, Shkolnikov VM et al. The recent mortalitydecline in Russia: beginning of the cardiovascular revolution?Popul Dev Rev 2014;40:107–29.5. Karlinsky A, Kobak D. Tracking excess mortality across coun-tries during the COVID-19 pandemic with the World MortalityDataset. eLife 2021;10:e69336.6. Kobak D. Excess mortality reveals Covid’s true toll in Russia.Significance 2021;18:16–19.7. Timonin S, Klimkin I, Shkolnikov VM, Andreev E, McKee M,Leon DA. Excess mortality in Russia and its regions compared tohigh income countries: an analysis of monthly series of 2020.SSM - Population Health 2022;17:101006.8. World Health Organization. Gender and COVID-19: AdvocacyBrief. 2020. https://apps.who.int/iris/bitstream/handle/10665/332080/WHO-2019-nCoV-Advocacy_brief-Gender-2020.1-eng.pdf (21 March 2022, date last accessed).9. Islam N, Jdanov DA, Shkolnikov VM et al. Effects of covid-19pandemic on life expectancy and premature mortality in 2020:time series analysis in 37 countries. BMJ 2021;375:e066768.10. Mukhina N, King SJ. Making sense of COVID-19 vaccinehesitancy in Russia: Lessons from the past and present. TheConversation. http://theconversation.com/making-sense-of-covid-19-vaccine-hesitancy-in-russia-lessons-from-the-past-and-present-165716 (6 December 2021, date last accessed).11. Nast C. Why Russia Hasn’t Cracked Down on COVID-19. TheNew Yorker. 2021. https://www.newyorker.com/news/dispatch/why-russia-hasnt-cracked-down-on-covid-19 (6 December 2021,date last accessed).12. Andrasfay T, Goldman N. Reductions in 2020 US life expect-ancy due to COVID-19 and the disproportionate impact on theBlack and Latino populations. Proc Natl Acad Sci U S A 2021;118:e2014746118.13. Åslund A. Responses to the COVID-19 crisis in Russia, Ukraine,and Belarus. Eurasian Geogr Econ 2020;61:532–45.14. Burakovsky A. Russia’s COVID-19 response slowed by populationreluctant to take domestic vaccine. The Conversation. http://theconversation.com/russias-covid-19-response-slowed-by-population-reluctant-to-take-domestic-vaccine-165925 (6 December 2021,date last accessed).15. Castro MC, Gurzenda S, Turra CM, Kim S, Andrasfay T,Goldman N. Reduction in life expectancy in Brazil afterCOVID-19. Nat Med 2021;27:1629–35.16. Lima EEC, Vilela EA, Peralta A et al. Investigating regional ex-cess mortality during 2020 COVID-19 pandemic in selectedLatin American countries. Genus 2021;77:30.17. COVID-19 Data Explorer. Our World in Data. https://ourworldindata.org/coronavirus-data-explorer (25 October 2021, datelast accessed).18. Silcocks PB, Jenner DA, Reza R. Life expectancy as a summaryof mortality in a population: statistical considerations and suit-ability for use by health authorities. J Epidemiol CommunityHealth 2001;55:38–43.International Journal of Epidemiology, 2022, Vol. 51, No. 5 1697Downloaded from https://academic.oup.com/ije/article/51/5/1695/6555070 by guest on 21 December 2022

Life expectancy declines in Russia during the COVID-19 pandemic in 2020

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